Persistent Food Insecurity, but not HIV, is Associated with Depressive Symptoms Among Perinatal Women in Kenya: A Longitudinal Perspective

Tuthill, Emily L.; Maltby, Ann E; Conteh, Jalang; Sheira, Lila A; Miller, Joshua D.; Onono, Maricianah; Weiser, Sheri D.; Young, Sera L.

doi:10.1007/s10461-020-03047-1

Cited by 15 publications

(17 citation statements)

References 46 publications

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“…However, apart from these studies, there are no other studies from LMICs that used nationally representative data sets of the general population. Other studies from LMICs that have focused on the relationship between food insecurity and depression have utilized specific populations such as mothers who recently gave birth and people living with HIV, and thus, generalizability is severely limited (Ayano et al, 2020; Dewing et al, 2013; Khoshgoo et al, 2020; Natamba et al, 2017; Tuthill et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Association between food insecurity and depression among older adults from low‐ and middle‐income countries

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McDermott

Jacob

et al. 2021

Depression and Anxiety

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Background To examine the association between self‐reported food insecurity and depression in 34,129 individuals aged ≥50 years from six low‐ and middle‐income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). Methods Cross‐sectional, community‐based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Self‐reported past 12‐month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12‐month DSM‐IV depression. Multivariable logistic regression analysis and meta‐analysis were conducted to assess associations. Results In total, 34,129 individuals aged ≥50 years [mean (SD) age, 62.4 (16.0) years; 52.1% females] were included in the analysis. Overall, the prevalence of moderate and severe food insecurity was 6.7% and 5.1%, respectively, while the prevalence of depression was 6.0%. Meta‐analyses based on countrywise estimates showed that overall, moderate food insecurity (vs. no food insecurity) is associated with a nonsignificant 1.69 (95% confidence interval [CI] = 0.82–3.48) times higher odds for depression, while severe food insecurity is significantly associated with 2.43 (95% CI = 1.65–3.57) times higher odds for depression. Conclusions In this large representative sample of older adults from six LMICs, those with severe food insecurity were over two times more likely to suffer from depression (compared with no food insecurity). Utilizing lay health counselors and psychological interventions may be effective mechanisms to reduce depression among food‐insecure populations. Interventions to address food insecurity (e.g., supplemental nutrition programs) may reduce depression at the population level but future longitudinal studies are warranted.

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Section: Introductionmentioning

confidence: 99%

Association between food insecurity and depression among older adults from low‐ and middle‐income countries

Smıth

McDermott

Jacob

et al. 2021

Depression and Anxiety

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“…Our finding that greater depressive symptomatology was associated with higher odds of severe FI aligns with previous work among pregnant and postpartum populations in low-and middle-income settings. 17,[40][41][42] It is unclear, however, whether depressive symptomatology precedes or is a product of FI. Previous work in the United States supports a potential bidirectional relationship: The stress of FI increases the risk of depression, and depression may lead to FI by reducing an individual's social and economic capital.…”

Section: Discussionmentioning

confidence: 99%

“…Time points at which food insecurity and psychosocial measures were collected among Kenyan women enrolled in the Pith Moromo/Pii En Ngima study. Adapted from the study by Tuthill et al 40 FI indicates food insecurity; Psych, psychosocial measures (Center for Epidemiologic Studies-Depression scale and the Duke/UNC Functional Social Support Scale).…”

Section: Methodsmentioning

confidence: 99%

Prevalence and Covariates of Food Insecurity Across the First 1000 Days Among Women of Mixed HIV Status in Western Kenya: A Longitudinal Perspective

et al. 2021

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Background: Food insecurity (FI) is common globally and can have lifelong consequences. However, few studies have longitudinally examined how FI varies across gestation and the postpartum period (“the first 1000 days”); none have explored this in sub-Saharan Africa or in the context of HIV. Objective: To assess the prevalence and covariates of FI in the first 1000 days among Kenyan women. Methods: All pregnant women attending 7 clinics in western Kenya (n = 1247) were screened for HIV and FI (Individual Food Insecurity Access Scale) between September 2014 and June 2015. A subset of women (n = 371) was recruited into an observational cohort study and surveyed 11 times through 2 years postpartum (NCT02974972, NCT02979418). Data on FI, sociodemographics, and health were repeatedly collected. Severe FI was modeled using multilevel, mixed-effects logistic regressions (n = 346). Results: Of the 1247 pregnant women screened, 76.5% were severely food insecure in the prior month. Further, the prevalence of severe FI was higher among women living with HIV than those without (82.6% vs 74.6%, P < .05). In the cohort, the odds of being severely food insecure decreased monotonically after delivery. Each point higher on the Center for Epidemiologic Studies-Depression scale was associated with 1.08 times greater odds of being severely food insecure (95% CI: 1.05-1.10); each point higher on the Duke/UNC Functional Social Support Scale was associated with 0.97 lower odds of severe FI (95% CI: 0.94-0.99). Conclusions: Severe FI is prevalent during the first 1000 days in western Kenya. Services to mitigate the far-reaching consequences of this modifiable risk should be considered.

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“…Between March 2019-March 2020, we conducted semi-structured interviews lasting between 60 and 90 min at three consequential time points (i.e., 28–38 weeks pregnant, 6-weeks postpartum, and 5–7 months postpartum). The interviews elicited information on a range of topics based on our previous research [ 25 , 26 ], and review of the literature. The interview guide included questions pertaining to the women’s feelings about their pregnancy and their HIV status, their experiences with HIV care, social support and access to food.…”

Section: Methodsmentioning

confidence: 99%

“…26: "P: Sometimes I don't have money for fare that's why I send my daughter to come and collect my medicines for me because for me to walk to 'Riat' [Name of place] it will take time or I will be late. If I don't have fare, I tell myself that I will come the following week but I do receive a phone call asking why I did not go to the go to the clinic for my medication.…”

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confidence: 99%

“I Found Out I was Pregnant, and I Started Feeling Stressed”: A Longitudinal Qualitative Perspective of Mental Health Experiences Among Perinatal Women Living with HIV

et al. 2021

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Globally, depressive symptoms among pregnant and postpartum (i.e., perinatal) women living with HIV (WLWH) are alarmingly high and associated with poor outcomes such as suboptimal adherence to antiretroviral therapy (ART), and early cessation of exclusive breastfeeding (EBF). Few qualitative studies have described the experience of perinatal depression among WLWH to identify the underlying social-structural determinants of poor mental health and potential strategies to intervene. We conducted a longitudinal qualitative study applying semi-structured interviews with 30 WLWH at three timepoints (28–38 weeks pregnant, 6-weeks postpartum and 5–7 months postpartum) to understand mental health experiences of perinatal WLWH in western Kenya. Financial insecurity emerged as the central theme impacting the mental health of women across time. Financial insecurity was often attributed to the loss of employment, related to pregnancy and the demands of breastfeeding and caring for an infant, as well as a lack of support from male partners. The loss of income and subsequent financial strain contributed to worsening levels of food insecurity and relationship stress and challenged engagement in HIV care. In this way, increased financial strain during the perinatal period negatively impacted the mental health of perinatal WLWH. Our findings suggest support to meet basic needs and remain engaged in HIV care during pregnancy and postpartum could improve perinatal mental health for WLWH in this setting.

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Persistent Food Insecurity, but not HIV, is Associated with Depressive Symptoms Among Perinatal Women in Kenya: A Longitudinal Perspective

Cited by 15 publications

References 46 publications

Association between food insecurity and depression among older adults from low‐ and middle‐income countries

Association between food insecurity and depression among older adults from low‐ and middle‐income countries

Prevalence and Covariates of Food Insecurity Across the First 1000 Days Among Women of Mixed HIV Status in Western Kenya: A Longitudinal Perspective

“I Found Out I was Pregnant, and I Started Feeling Stressed”: A Longitudinal Qualitative Perspective of Mental Health Experiences Among Perinatal Women Living with HIV

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